Well, let's talk a little about this surgery I have scheduled for Friday, January 8, 2010. Talking about it will help me mentally prepare, and will allow me to break through this denial bubble encircling my head (that's why we need to talk about it, Cary Tennis!!). It's time to deal with it, in concrete, real terms. Without delay or distraction.
But first, let's look at that date, January 8. Of course, it's the birthday of Elvis Presley. Elvis is everywhere. He's in your cheeseburgers.
Steven Hawking and David Bowie were also born on that day. Larry Storch from "F Troop," too. And it's "Commonwealth Day" in the North Mariana Islands. Back to the surgery.
But another quick delay, for a warning--these are links to pictures of surgery, so the images are kind of disgusting, at least to me.
A refresher--pseudomyxoma peritonei gets its start in the appendix. Here is a picture of a diseased appendix, ruptured: GROSS PICTURES. This link is to the eminent Dr. Sugarbaker's website. Mucus comes out of the appendix tumor, and the mucus spreads the cancer.
If you scroll down on that page (the above link), you can see how they have to dig around in my belly to look for the mucus and the tumors. This next quote is from the website of Carolyn Langlie-Lesnik, RN BSN:
Appendix cancer has often spread to the peritoneal surfaces of the abdomen by the time it is discovered. The surgery to remove as much of the cancer in the abdomen as possible, reducing the "bulk" of the cancer is called "debulking" or "cytoreduction" surgery. "Cyto" is a word root meaning cells, so cytoreduction means to surgically "reduce" number of cancer cells. Both terms mean the same thing and are usually used interchangeably.Okay, this next link is to even worse images, click if you dare: MORE GROSSER PICTURES. The first image is the "cut along the dotted line" drawing. Self explanatory. Then if you scroll down you see Dr. Sugarbaker (I presume) in action. I understand that all doctors have different techniques, and I'm not sure exactly how my surgeon Dr. Fournier's surgery plan differs from Dr. Sugarbaker's, but this gives you the general idea.
Cytoreduction (debulking) surgery is often long and complicated and is associated with a high rate of post-operative complications. Parts of the large and small bowel along with organs or parts of organs in the abdomen that are cancerous may need to be removed during this surgery. "Complete cytoreduction" or "complete debulking" means that all of the visible tumors are successfully removed during surgery. "Incomplete cytoreduction" or "incomplete debulking" means that all of the tumors could not be removed during the surgery and that visible tumors were left behind.
The factor most associated with long term survival is completeness of cytoreduction, or the removal of all visible tumors. Cytoreduction (debulking) surgery is best done by a surgical oncologist who specializes in these types of surgeries.
Okay, that's about all I can handle right now. Tomorrow or the next day I'll explain the HIPEC procedure in more detail.